ATI - pain

Question 1

define pain threshold vs pain tolerance

Answer 1

threshold: point which a person perceives pain; min
tolerance: level of pain they will endure; max

Question 2

transduction

Answer 2

sensory neurons feels tissue damage through neurotransmitter sensitization of nociceptors

Question 3

how do NSAIDs work

Answer 3

block products of pain response such as prostaglandins

Question 4

transmission

Answer 4

pain impulse travels from peripheral nerves to somatic sensory cortex where pain is perceived

Question 5

how do opioids work

Answer 5

inhibits pain transmission from peripheral nerves to somatic sensory cortex

Question 6

why use adjuvant medications such as antidepressants

Answer 6

they modulate pain by promoting reuptake of endorphins

Question 7

what does the gate-control theory say

Answer 7

• pain varies between the balance of non-nociceptive info traveling into spinal cord via large nerve fibers + nociceptive info traveling through spinal cord through small nerve fibers.
• if the large nerve fibers are more active, the gate is closed and person should feel little to no pain.
• if the smaller nerve fibers are more active, the projector neurons will activate and block inhibitory neurons, which then leads to pain.

BIG idea: nondrug therapy works for pain

Question 8

OPQRST mnemonic

Answer 8

Onset
Provocation
Quality
Region
Severity
Time

Question 9

define acute vs. chronic pain

Answer 9

acute: resolves after damaged tissue heals
chronic: persists 6 months or more past the expected healing time

Question 10

side effects of acute pain

Answer 10

sympathetic nervous system activates: increased HR, BP, diaphoresis, pallor, dry mouth, nausea, bronchiolar dilation, etc.

reduced gastric secretion/motility, increased bg, decreased urine output

Question 11

side effects of chronic pain

Answer 11

vitals become stable so behavioral changes are more noted: depression, withdrawn.

pain-reducing substances are depleted and pain msg is sent faster so increases pts response to pain.

Question 12

define nociceptive pain

Answer 12

• damage or inflammation of tissue.
• somatic (msk) or visceral.

Question 13

define neuropathic pain

Answer 13

• abnormal or damaged pain nerves
• ex: postherpetic neuralgia (adjuvant meds better instead of typical opioids or NSAIDS), phantom pain

Question 14

idiopathic pain

Answer 14

chronic pain that continues despite no detectable cause
ex: complex regional pain syndrome

Question 15

referred pain

Answer 15

starts in one region from actually in another region
ex: gall bladder dx feels pain in shoulder blade

Question 16

radiating pain

Answer 16

pain felt near the source

Question 17

intractable pain

Answer 17

defies relief
ex: advanced maglignancies

Question 18

infants perception of pain

Answer 18

crying or withdraw

Question 19

toddlers perception of pain

Answer 19

crying or anger
pain is associated with punishment or threat to their security

Question 20

school-age children or adolescents perception of pain

Answer 20

view pain as weakness
tend to not acknowledge right away
learn certain acceptable pain such as sports

Question 21

adults perception of pain

Answer 21

how they learned to express pain as a child

Question 22

older adults perception of pain

Answer 22

dx that impair perception of pain such as neuropathy, chronic pain
reluctant to express pain

Question 23

patient teachings for when to give meds

Answer 23

tell pt to tell you when pain is mild and after intervention, reassess no more than 1 hr after

Question 24

when do IV and oral pain meds peak

Answer 24

IV: 30 mins
oral: 1 hr

Question 25

CRIES scale usage, and stands for

Answer 25

for infants: 0-6m

scores 0-2 in 5 categories

Crying
increase in O2 REquirement from baseline
Increase in vitals
Expression on face
Sleeping

Question 26

FLACC scale usage, and stands for

Answer 26

for infants and kids 2m-7yrs old when not verbal

Facial expression
Leg movement
Activity
Crying
Consolabiliity

Question 27

what pain scale is used for advanced dementia pts

Answer 27

PAINAD
Breathing, negative vocalization, facial expression, body language, consolability

Question 28

when is the COMFORT behavioral scale used

Answer 28

pts who can’t use traditional numeric rating or FACES scale

Question 29

biofeedback therapy

Answer 29

devices with electrode sensors that monitor physiological response to pain, to help the pt determine what methods are good for relieving their pain

Question 30

how fast should IV opioids be injected

Answer 30

slowly over 4-5 mins